Newborn killings drop after anonymous delivery law

NEW YORK (Reuters Health) - Allowing women to anonymously deliver their babies in a hospital was associated with a drop in the number of newborns killed by their mothers, according to a new study.

That suggests that the laws are correctly targeted at the problem, say researchers.

"We assume the law gives women who are desperate, who deny their pregnancy, who become aware of the pregnancy too late or experience denial in the first two trimesters a chance to get out of the situation," Claudia Klier, an author of the study, told Reuters Health. "This gives them a solution."

Austrian police statistics showed a 57 percent drop in neonaticides, to 3.1 per 100,000 births, after that country adopted in 2001 a law permitting anonymous - and free - hospital delivery. Over the same period, neonaticide rates held steady in Finland and Sweden, which didn't have such a law.

The study appears in BJOG: An International Journal of Obstetrics and Gynecology.

The findings suggest that the laws, which also exist in some European countries including France, Luxembourg and Italy, may play a role in reducing neonaticide, defined as the homicide of an infant by its mother within 24 hours of delivery. The study can't prove the Austrian law caused the drop, however, since it was based on observations after the fact.

Still, the authors said they could identify no other "socioeconomic or policy changes in Austria that could be associated with the observed decrease, such as the passage of abortion laws or changes regarding childbirth benefits."

BABY HATCHES?

A host of factors are linked to neonaticide, including denial of the pregnancy and a history of trauma and troubled relationships, according to the study. Research previously conducted in France suggested that women who would abandon their babies in a hospital think about harming the child while pregnant, said Klier, an associate professor of child and adolescent psychiatry at the Medical University of Vienna.

Other methods for reducing neonaticide include "baby hatches," incubators placed outside hospitals that alert hospital workers when someone leaves a baby inside. In the U.S., the chief strategy has been so-called safe haven laws, which allow parents to easily surrender their babies at locations such as police stations and hospitals. There are limited data to support safe haven laws, according to the researchers.

Klier said an estimated 30 to 40 women take advantage of the anonymous birth law in Austria each year, compared to two to three who use the baby hatches.

Austrian neonaticide rates were higher to begin with, at 7.2 per 100,000 births, than in Finland and Sweden, at 1.6 and 1.8 respectively. Rates in those two countries were little changed over the study period.

CRIME 'REALLY UNDERESTIMATED'

The study results were "wonderful," said Susan Hatters Friedman, an associate professor of clinical psychiatry and pediatrics at Case Western Reserve University School of Medicine, who has studied neonaticide.

The crime is "really underestimated," making the police statistics only the "tip of the iceberg," she said. "If a woman can hide the pregnancy, she can hide the body."

The study authors emphasized the need for greater awareness of the laws. Austria no longer has an active publicity campaign following concerns that women might use anonymous delivery as a substitute for regular adoption procedures, Klier said.

"We cannot catch all" of the would-be neonaticides, but "the number could be reduced further," she said.